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Characteristics and management of macular hole developing after rhegmatogenous retinal detachment repair
Mehmet Giray Ersoz1, Mumin Hocaoglu2, Isil Sayman Muslubas2
1Department of Ophthalmology, Biruni University Medical School, İstanbul, Turkey.
Purpose:
To report characteristics of patients developing full-thickness macular hole (MH) after rhegmatogenous retinal detachment (RRD) repair surgery. We also compared patients developing MH with and without accompanying RRD recurrence regarding anatomical and visual outcomes of MH repair.
Design:
Retrospective study.
Methods:
Medical records of patients who developed MH after RRD repair between January 2002 and January 2018 were reviewed.
Results:
We performed 1661 primary RRD operations during the study period and 14 of these developed MH, an incidence of 0.8%. Nine patients had their primary RRD repair surgery in another clinic and were referred to our clinic after development of MH. In total 23 patients with MH secondary to RRD repair were included in the study. The type of RRD repair surgery was scleral buckling only in 4 patients (17%), pars plana vitrectomy (PPV) only in 14 patients (61%), and sequential scleral buckling and PPV in 5 patients (22%). Nineteen patients (83%) had macula-off RRD. In 12 patients (52%), MH developed within 3 months after RRD repair. Surgery for MH repair was performed in 18 patients. Postoperative best corrected visual acuity (BCVA) was better than preoperative BCVA in the group with RRD recurrence as well as in the group without RRD recurrence (both P < 0.05). There wasn't a significant difference between these groups regarding postoperative visual gain and anatomical success (P > 0.05).
Conclusion:
MH can develop after various surgical methods of RRD repair. Anatomic closure and visual acuity gain can be achieved even if patients have accompanying RRD recurrence.
Insights
Macular holes (MH) can occur after surgery for rhegmatogenous retinal detachment (RRD). Successful anatomical closure and visual improvement are achievable for MH repair, even with recurrent RRD.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Rhegmatogenous retinal detachment (RRD) repair is a common surgical procedure.
- Macular holes (MH) can be a rare complication following RRD repair surgery.
Purpose of the Study:
- To characterize patients who develop full-thickness macular holes (MH) after rhegmatogenous retinal detachment (RRD) repair.
- To compare anatomical and visual outcomes of MH repair in patients with and without concurrent RRD recurrence.
Main Methods:
- Retrospective review of medical records.
- Inclusion of 23 patients who developed MH after RRD repair between 2002 and 2018.
- Analysis of surgical methods for RRD repair and MH repair outcomes.
Main Results:
- An incidence of 0.8% for MH development after RRD repair was observed (14 of 1661 cases).
- Pars plana vitrectomy (PPV) was the most common primary RRD repair method (61%).
- Postoperative visual acuity and anatomical success rates were similar between groups with and without RRD recurrence.
Conclusions:
- Macular hole development is a potential complication across various RRD repair surgical techniques.
- Successful anatomical closure and visual gains are attainable in MH repair, irrespective of RRD recurrence.
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